Abstract
ABSTRACTObjective and Hypothesis We aimed to investigate the reasons of storage symptoms ( SS) after transurethral resection of the prostate (TURP). The hypothesis was that a positive correlation would be identified between preoperative and postoperative SS in patients with undergoing TURP and starting early solifenacin treatment in patients with high preoperative SS would be reasonable. In addition, we aimed to analyze multiple other risk factors for post-TURP SS.Materials and Methods A total of 160 patients undergoing TURP were prospectively evaluated and divided into two groups according to their OABS. Those with a score of ≥10 points were Group 1 (G1), and those with <10 points Group 2 (G2). In addition, patients in each group were randomly further divided into two subgroups: those who were started on 5 mg solifenacin succinate in the early postoperative period (G1/G2 A) and those who were not (G1/G2 B). In additions to SS Preop, perop and at the 3rd-month of postoperatively 14 variable were evaluated. The effects of these factors, surgery and the efficacy of an early medical treatment on the postoperative SS were investigated. LUTS were assessed by International Prostate Symptom Score (IPSS) and SS were assessed by sum of IPSS 2, 4 and 7 questionnaires (Storage, S- IPSS).Results Preoperative IPSS and S-IPSS were significantly higher in G1 (p<0.001); there was a significant improvement at IPSS, S-IPSS, QoL score, Qmax, and PVR for all groups after surgery. Only preoperative S-IPSS was found to have significant effect on postoperative SS (p<0.001). There was a significant difference between G1A and G1B but no significant difference between G2A and G2B in terms of SS at postoperatively. In addition to this, prostatic volume was found smaller than non-symptomatic patients in de novo SS patients.Conclusion TURP provides significant improvement in both storage and voiding symptoms. The predictive value of the preoperative S-IPSS on postop SS is significant. These results suggest that 5 mg solifenacin succinate treatment in the early postoperative period may be beneficial for patients with high preoperative SS and may not be beneficial in others. Small prostatic volume may bode ill for postoperative SS in the patients with de novo SS.
Highlights
Transurethral resection of the prostate (TURP) is the most effective surgical treatment option for benign prostatic hyperplasia (BPH) and is still the gold standard and it has been shown to provide significant, sustained decrease in lower urinary tract symptoms (LUTS) and improvements in urodynamic parameters [1]
Several studies have shown that the success rates in the postoperative period were lower in patients with preoperative urodynamic detrusor overactivity (DO) and preoperative severe SS, the data on this subject are contradictory [4,5,6,7,8,9,10,11]
Patient’s LUTS were assessed by International Prostate Symptom Score (IPSS) and SS scores were assessed by total scores of İPSS 2, 4 and 7 questionnaires (S-IPSS) because IPSS was validated in many languages around the World, safely used in previous studies, and its use is more convenient
Summary
Transurethral resection of the prostate (TURP) is the most effective surgical treatment option for benign prostatic hyperplasia (BPH) and is still the gold standard and it has been shown to provide significant, sustained decrease in lower urinary tract symptoms (LUTS) and improvements in urodynamic parameters [1]. It has been reported that overactive bladder symptoms (OABS) persist in 2035% of cases after TURP [3]. It is important for the surgeon and patients to know which group of patients is under risk for development of OABS after TURP. Several studies have shown that the success rates in the postoperative period were lower in patients with preoperative urodynamic detrusor overactivity (DO) and preoperative severe SS, the data on this subject are contradictory [4,5,6,7,8,9,10,11]. We aimed to investigate the reasons of SS after transurethral resection of the prostate (TURP). We aimed to analyze multiple other risk factors such as age, PSA, prostatic volume, energy sources, resection time, duration of postoperative catheterization, pathology results etc. for post-TURP SS including de-novo SS and nocturia
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